International Journal of Computer Science Trends and Technology (IJCST) Volume1 Issue2, Nov-Dec 2013

A Survey on Clustering Techniques in Medical Diagnosis

N.S.Nithya1, Dr.K.Duraiswamy2, P.Gomathy3,
Department of Computer Science and Engineering
K.S.R.College of Engineering, India.

ABSTRACT
Due to recent technology advances, large masses of medical data are obtained. These large data contain valuable information
for diagnosing diseases. Data mining techniques can be used to extract useful patterns from these mass data. It provides a
user- oriented approach to the novel and hidden patterns in the data. One of the major challenges in medical domain is the
extraction of comprehensible knowledge from medical diagnosis data. Healthcare system becomes very important to develop
an automated tool that is capable of identifying and disseminating relevant healthcare information. This paper intends to
provide the survey of various clustering techniques used in medical field. The purpose of this survey is to improve the design
of clustering methods for further enhancement
Keywords- Medical data mining, Hierarchical, Partitioning, Density Based, K-NN Nearest neighbor clustering techniques.

I. INTRODUCTION
The medical expert system interest for independent decisions in medical and engineering
applications is growing, as data becomes easily available. In a previous, an exponential in enhancement
has been witnessed in the accuracy and sensitivity of diagnostic tests, from observing external symptoms
and using sophisticated lab tests and complex imaging methods increasingly that permit detailed non-
enveloping internal examinations. This improved accuracy has certainly resulted in an exponential
increase in the patient data available to the physician. The process of obtaining evidence to identify a
probable cause of patient's key symptoms from all other possible causes of the symptom are known as
establishing a medical diagnosis[1].
Data Mining Techniques applied in many application domains like e-business, Marketing,
Health care and Retail have led to its application in other industries and sectors. Medical data mining has
great potential for exploring the hidden patterns in the data sets of the medical field. These patterns can
be utilized for clinical diagnosis. But the available raw medical data are widely in the form of distributed
in nature and large. These data need to be compiled in an organized pattern. Medical diagnosis is
regarded as an important yet complex task that needs to be done accurately and efficiently. The
Healthcare environment is still information rich but knowledge poor [2].
Data mining technology provides a user oriented approach to the novel and hidden patterns in
the data. However, there is a lack of effective analysis tools to discover hidden relationships and trends
in data. Data mining is an essential step in the process of knowledge discovery in databases in which
intelligent methods are used in order to extract patterns. Many techniques available in data mining such
as classification, clustering, association rule, decision trees and artificial neural networks [3]. Clustering
is grouped by the similarity data. Each group called clusters, the group consisting object can be similar
and dissimilar from other groups. Clustering partitions a data set into several groups such that the
similarity within a group is larger than that among groups. Large amount of data, we usually tend to
summarize this huge number of data into a small number of groups or classes in order to further
facilitate its analysis. This paper provides to analyze the different clustering techniques in diagnosis the
medical disease.
II. RELATED WORK
Medical diagnosis is known to be subjective and depends not only on the available data but also
on the experience of the physician and even on the psycho-physiological condition of the physician. A
number of studies have demonstrated that the diagnosis of one patient can differ significantly if the
patient is tested by different physicians or even by the same physician at various times. Healthcare

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International Journal of Computer Science Trends and Technology (IJCST) Volume1 Issue2, Nov-Dec 2013

related data mining is one of the most rewarding and challenging field of application in data mining and
knowledge discovery. The reason for challenging is due to the data sets of huge, complex, diverse,
hierarchical, time series and varying in quality. As the available healthcare datasets are fragmented and
diffused in nature, thereby making the process of data integration is a highly challenging task [4].
Considering a small subset of medical datasets, algorithms have been formed and accurate results
have been achieved by some of them [5]. Applied to a much larger generalized dataset, for every
medical field, obtaining accurate results has yet been very difficult. Liad[6] is an expert system program
that uses Bayesian classification to estimate the posterior probabilities of various diagnoses under
consideration, given the symptoms present in a case.
DXplain is a Clinical decision support system (CDSS) available through the World Wide Web
that assists clinicians by generating stratified diagnoses based on user input of patient signs and
symptoms, laboratory results, and other clinical findings. DXplain generates ranked differential
diagnoses using a pseudo-probabilistic algorithm. Each clinical finding entered into DXplain is assessed
by determining the importance of the finding and how strongly the finding supports a given diagnosis
for each disease in the knowledge base. Using this criterion, DXplain generates ranked differential
diagnoses with the most likely diseases yielding the lowest rank. Using stored information regarding
each diseases prevalence and significance, the system differentiates between common and rare diseases.
DXplain takes the advantage of a large database of the crude probabilities of different clinical
manifestations associated with different diseases, but unfortunately, it is still confined to the research
laboratory or medical training setting[6].
The rest of the work is organized as Section 3 gives literature survey different clustering
techniques and Section 4 describes Conclusion.

III. LITERATURE SURVEY

Clustering Techniques
Clustering is an unsupervised data mining (machine learning) technique used for grouping the
data elements without advance knowledge of the group definitions. The objective of clustering is to find
the intrinsic grouping in a set of unlabeled data. Transform the set of features into subsets so that
features in the same subset are similar in some sense shown in Fig-1.

Figure 1.clustering
A. Hierarchical Clustering

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International Journal of Computer Science Trends and Technology (IJCST) Volume1 Issue2, Nov-Dec 2013

Hierarchical clustering builds a cluster hierarchy is known as a dendrogram. Every cluster node
contains child clusters, sibling clusters divider the points their common parent. Hierarchical clustering
methods are categorized into agglomerative and divisive. An agglomerative clustering starts with one-
point clusters and recursively merges two or more most appropriate clusters. Compute all pair wise
pattern-pattern similarity coefficients. Place each of and patterns in a class of its own. Merge the two
most similar clusters into replacing the two clusters into the new cluster and re-compute inter-cluster
similarity scores. Merge the two most similar clusters into replacing the two clusters into the new cluster
and re-compute inter-cluster similarity scores. The above step until there are k clusters left (k can be 1).
A divisive clustering starts with one cluster of all data points and recursively splits the most
appropriate cluster. Start at the top with all patterns in one cluster. The cluster is split using a flat
clustering algorithm. This procedure is applied recursively until each pattern is in its own singleton
cluster. Chipman et al., proposed the hybrid hierarchical clustering approach for analyzing microarray
data [7].The research work combines both top-down and bottom-up hierarchical clustering concepts in
order to effectively utilize the strength of this clustering approach. Chen et al., proposed an integrated
approach for analyzing micro- array data. Belciug use the hierarchical clustering approach for grouping
the patients according to their length of stay in the hospital that enhance the capability of hospital
resource management [8].Figure 2 shows the grouping of the patients into two cluster using 192-gene
expression profile. Liu et al., predict the severity of disease in patients using gene expression profile
having Rheumatoid Arthritis [9].
The advantages of hierarchical clustering are embedded flexibility regarding the level of granularity,
ease of handling of any kinds of similarity or distance, consequently, applicability to any attribute types.
The Disadvantage of hierarchical clustering is related to Vagueness of termination criteria [10].

Fig-2. Hierarchical Clustering for Grouping the Gene data into Two Cluster using 192-Gene Expression
Profile.
B. Partition Methods

Partition algorithms construct partitions of a database of N objects into a set of k clusters. The
partitioning clustering algorithm usually adopts the Iterative Optimization. Specifically, this means
different relocation schemes that iteratively reassign points between the k clusters. This algorithm can be
categorized k-means and k-medoids. K means is very simple and easily implemented. It is a simple
iterative method to recover the user specified number of cluster k which is symbolized by the centroids.
It presents no limitations on attribute types the choice of methods is dictated by the position of a
predominant fraction of points inside a cluster and, consequently, it is lesser sensitive to the presence of.

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International Journal of Computer Science Trends and Technology (IJCST) Volume1 Issue2, Nov-Dec 2013

The grouping of person on the basis of high blood pressure and cholesterol level into high risk and low
risk of having heart disease using K-means clustering. Lenert et al., utilize the application of k-means
clustering in the health services of public domain [11] and Belciug et al. Detect the recurrence of breast
cancer with the help of clustering techniques. The advantage is a simple clustering approach and
efficient. The disadvantages require a number of clusters in advance and not discover the cluster with
non-convex shape [12].

Fig- 3. K-means clustering for heart disease patients.

C. Density Based Clustering

The density based cluster is discovering the clusters of arbitrary shapes and the noise in a spatial
database. It uses two parameters Epsilon and Minimum Points of each cluster and at least one point from
the respective cluster. The number of neighbors is greater than or equal to minimum points, a cluster is
formed. It vends all the neighbor points within distance epsilon of the starting point. The cluster is fully
expanded then the algorithm proceeds to iterate through the remaining invested points in the dataset.
One disadvantage is cannot cluster data sets well with large differences in densities. It maintains the set
of objects in three different categories such as classified, unclassified and noise. Each classified object
has an associated cluster id. A noise object may also have an associated dummy cluster id.
Unclassified object does not have any cluster id. This research discovers the area of homogeneous
color in biomedical images. This method separates the unhealthy skin or wound from healthy skin and
discovers the sub regions of varied color or spotted part inside the unhealthy skin which is again useful
for classification and association task [13]. Figure-4 shows the clustering of injured skin images using
DBSCAN algorithm. The advantage is no need to specify the number of clusters in advance and easily
handle cluster with arbitrary shape. The disadvantage is not handling the data points with varying
densities and results depend on the distance measures.

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International Journal of Computer Science Trends and Technology (IJCST) Volume1 Issue2, Nov-Dec 2013

Figure- 4. Clustering of injured skin image using DBSCAN

D. K-Nearest-Neighbour (KNN)
KNN is one of the most simple and straight forward data mining techniques. It is called
Memory-Based Classification as the training examples need to be in the memory at run-time. K-NN is a
type of instance-based learning, or lazy learning where the mapping is only approximated locally and all
computation is deferred until classification. When dealing with continuous attributes the difference
between the attributes is calculated using the Euclidean distance. KNN usually deals with continuous
attributes however it can also deal with discrete properties. Given a query instance x to be classified,_
Let x1,x2.xk denote the k instances from training examples that are nearest to xk .Return the class that
represents the maximum of the k instances. Particle Swarm Optimization (PSO) was also used for
specifying fuzzy strength constraint and neighbourhood size. Zuo et al., also introduced an adaptive
fuzzy K-NN approach for Parkinson disease [14].

Figure 5.KNN for chronic disease

Distance usually relates to all the attributes and assumes all of them have the same effects on
distance. The similarity metrics do not consider the relation of attributes which result in inaccurate
distance and then impact on classification precision. KNN advantages is easy to implement and training
in faster. Disadvantages is require large database, sensitive to noise, and testing is slow [15].
IV. CONCLUSION
In this paper, different clustering techniques were studied and their advantages and drawbacks
have been discussed. The different methods of clustering have been used to extract the useful patterns
and thus the knowledge from this variety databases. Selection of data and methods for clustering is an

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International Journal of Computer Science Trends and Technology (IJCST) Volume1 Issue2, Nov-Dec 2013

important task in medical diagnosis and needs the knowledge of the domain. The main focus of this
survey of clustering techniques is to how the clustering techniques applied in medical field. Each
clustering is suitable for some medical applications. An efficient clustering method should be selected
that suits desired task.

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